[NP-Clinical] Chicken pox

[Stephanie Walker]

As far as titer: it might work the same as measles, mumps and rubella  
testing: She did the acute titer, she just has to draw a convalescent  
titer and compare them.

I would see him for follow up to make sure his lesions don't get  
infected, as he's a diabetic. They could get infected with the usual  
bacteria, but I think that invasive strep has occurred more  
frequently in diabetics and more frequently as a complication of  
varicella.

Stephanie Walker, FNP

On Aug 1, 2007, at 9:04 AM, Mary Beck wrote:

> Hi Ann,
>   Are you sure it's chicken pox and not zoster? Are the lesions on  
> one side or generalized over the entire trunk? Usually adults with  
> chicken pox are sicker-fever, headache, malaise, anorexia. I've  
> found that the sensations along the involved nerve route with  
> herpes zoster and herpes simplex 2 can range from decreased  
> sensation/numbness to tingling, extreme pain and burning. Your  
> varicella titer might not be positive because it's too early to  
> mount a sufficient antibody response. Supportive care is prudent,  
> as is avoiding pregnant women, immunocompromised people, etc.
>
> Mary Beck, NP
>
> ----- Original Message -----
> From: arezendes at aol.com
> To: np-clinical at nurse.net
> Sent: Tuesday, July 31, 2007 7:14 PM
> Subject: [NP-Clinical] Chicken pox
>
> Hello listmates,
> I saw a 40 year old male with an initial case of chicken pox today.  
> Actually he called a week or so ago with symptoms consistent with  
> chicken pox. He came in today complaining about a decreased  
> sensation in his trunk and back area where the lesions are. The  
> lesions are in various stages of healing (no acute vesicles, just  
> scabbing and redness). No fever, chills, body aches, actually  
> feeling much better than he looked. I drew a CBC and varicella  
> titers, and told him to treat his symptoms. I am not sure if the  
> "decreased sensation" is related to the disease, nerve irritation  
> from the virus, etc. as I have never treated someone for this. He  
> is not having any numbness or tingling. Any thoughts? My  
> collaborative MD was out today.
> Thanks ahead,
> Ann NP
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